Nutrition and Feasiblity of Canteens

STUDY ON THE PERCEPTIONS OF GARMENT FACTORY

OWNERS ON NUTRITION AND THE FEASIBILITY FOR

PURSUING CANTEEN SERVICES IN THE GARMENT SECTOR

IN CAMBODIA

January 2012

Study on the perceptions of garment factory owners on nutrition and the feasibility for pursuing canteen services in the garment sector in Cambodia PAGE 2 OF 57

Researched conducted by BDLINK (Cambodia) and HRINC (Cambodia)

MARKET RESEARCH LEADERS. DATA DRIVEN INSIGHTS. TAKING BUSINESS BEYOND BORDERS. www.bdlink.com.kh and www.hrinc.com.kh

Acknowledgements

This study was conducted for HCFM, Hagar Catering Facilities Management, a leading social enterprise in

Cambodia providing jobs to young and vulnerable people (www.hagarcatering.com). We wish to thank Ms.

Rapytha Bonamy specifically and her team, for their time, coordination and inputs into the study.

The study was financially supported by the ILO Better Factories Cambodia (www.betterfactories.org/ilo)a

HRINC (Cambodia) (www.hrinc.com.kh)and BDLINK (Cambodia)(www.bdlink.com.kh).

We wish to thank Ms. Mona Tep, Director of the productivity division of the Society of Human Resource

Management and Productivity (SHRM&P) (www.shrmp.com.kh) for the use of their photos, all prepared by

James Grant Photography. In addition, Ms. Tep provided insights into the report and working conditions in

the factory given her extensive experience in the sector.

Also, thanks to the Garment Manufacturers Association in Cambodia (www.gmac-cambodia.org), Mr. Ken

Loo for his support in disseminating information about the survey to the industry and encouraging and

supporting the survey.

Finally, we wish to thank all the participating factories in this project. Thank you for your time and inputs

into the study. We have not listed individual names of people or companies to ensure confidentiality.




About the Research Teams and Authors

BDLINK Cambodia is Cambodia’s leading consulting research firm dedicated to providing clients with real

insights and understanding of the markets and environments.

HRINC Cambodia is Cambodia’s leading HR services firm providing a full suite of services from outsourcing,

recruitment to consulting and labour market studies. HRINC has a range of products in each division

providing clients with market insights that drive employee engagement and bottom line performance.

This is a collaborative study by the HRINC and BDLINK teams as part of our INSIGHTS! Initiative that aims to

provide the market with discussion and leadership papers on our economic environment. For more

information on our INSIGHTS initiative, please contact [email protected] or [email protected] U4T.

The project manager for this project was Ms. JoséVahl, General Manager of BDLINK Innovation and

Incubation division. Ms. Sandra D’Amico, Managing Director of HRINC was responsible for analytical,

reporting and recommendation frameworks. Research analysts for this project included Mr. Loch Leang

seng, Mr. Oum Chan Mono and Mr. Sok Kheang. The research analysts were responsible for on the ground

implementation and coordination including providing inputs and reviews on articulation as analytical and

recommendations are formed. The team represents Cambodia’s young and dynamic professional

workforce, each pursuing or completing their education and contributing to emerging challenges and

trends. Visit www.hrinc.com.kh and www.bdlink.com.kh for more information.

Photo 1:Cover - Outside the factory gate, where the workers eat (Courtesy of SHRM&P Cambodia)

mailto:[email protected]

mailto:[email protected]

http://www.hrinc.com.kh/

http://www.bdlink.com.kh/




Table of Contents

Acknowledgements ................................................................................................................................ 2

About the Research Teams and Authors .................................................................................................. 3

List of Figures ......................................................................................................................................... 5

List of Tables .......................................................................................................................................... 6

List of Photos ......................................................................................................................................... 6

Acronyms Used in the Study ................................................................................................................... 7

Executive Summary ................................................................................................................................ 8

Background .......................................................................................................................................... 11 Nutrition and the Cambodian garment sector ............................................................................................. 11

Study objectives and purpose of study .................................................................................................. 17 Methodology & Approach ............................................................................................................................ 17 Survey Constraints ........................................................................................................................................ 19

Survey findings ..................................................................................................................................... 20

1 Characteristics and profile of participating factories....................................................................... 20

2 Is nutrition important? Management perceptions .......................................................................... 27

3 Management perceptions on workers’ meals and cost of meals ..................................................... 29 3.1 Where workers eat: Management views ......................................................................................... 30 3.2 Management views on the cost of meals ......................................................................................... 31 3.3 Outside the factory gate: Management perceptions ....................................................................... 32

4 The link between nutrition and productivity: What are the factories’ views? .................................. 34

5 Canteen facilities and how they operate ........................................................................................ 38

6 Subsidising meals for workers: An opportunity or not? .................................................................. 40 6.1 A cost scenario for providing meals or subsidies to workers ............................................................ 41

7 Opportunities: shared canteen service facilities ............................................................................. 42

8 Concluding remarks & recommendations ...................................................................................... 44 8.1 General recommendations ............................................................................................................... 48 8.2 Recommendations for HCFM ............................................................................................................ 49

9 ANNEXES ...................................................................................................................................... 52 9.1 Scenarios on the cost of meals vs. income earnings......................................................................... 52

9.1.1 Caloric Intake ............................................................................................................................................... 54 9.1.2 Cost of a workers’ meal and economic data ............................................................................................... 55

9.2 Reference Materials ......................................................................................................................... 56 9.2.1 Typhoid ........................................................................................................................................................ 56

9.3 Value of Garments Manufacturing in relation to Cambodia’s GDP ................................................. 57




List of Figures

Figure 1: Monthly Expenditure on food for garment workers ......................................................................... 14

Figure 2: Relationship between sick leave, nutritional meals and factory canteens ....................................... 14

Figure 3: The cycle of poor nutrition and low national productivity ............................................................... 15

Figure 4: Project Approach ............................................................................................................................... 17

Figure 5: Summary of efforts to contact factories ........................................................................................... 18

Figure 6: Interview venue and respondent profile .......................................................................................... 19

Figure 7: Are you concerned about your employees’ health ........................................................................... 21

Figure 8: Perceptions on nutrition and responsibilities ................................................................................... 22

Figure 9: Employee composition and strength ................................................................................................ 23

Figure 10: Working hours in the factory .......................................................................................................... 24

Figure 11: BFC Synthesis reports on exceptional overtime and 2-hour limit ................................................... 24

Figure 12: Insurance provisions by factories .................................................................................................... 25

Figure 13: Characteristics of water provision, consumption and cost ............................................................. 26

Figure 14: Existing Canteen Facilities in Factories and Opportunities to Pursue Canteens ............................. 26

Figure 15: How important are nutrition and health challenges to factories? ................................................. 28

Figure 16: The importance of costs, productivity & skills ................................................................................ 28

Figure 17: Management perceptions on the cost of meals ............................................................................. 31

Figure 18: Perceptions on outside the factory gate ......................................................................................... 33

Figure 19: Does nutrition impact productivity? ............................................................................................... 35

Figure 20: Productivity and working hours and times ..................................................................................... 36

Figure 21: Workers and nutrition ..................................................................................................................... 36

Figure 22: Who is responsible? ........................................................................................................................ 37

Figure 23: Would you consider an outside service provider to run your canteen? ......................................... 39

Figure 24: Why do you not have a canteen? .................................................................................................... 39

Figure 25: How many meals are you willing to pay for? .................................................................................. 40

Figure 26: Willingness to pay for meals if provided by an outside provider .................................................... 41

Figure 27: Example of contributions from different stakeholders into a Joint Canteen ................................. 42

Figure 28: Perceptions on joint canteen facilities ............................................................................................ 43

Figure 30: Contribution to Cambodia's GDP per 3 main Industries of origin (at constant 2000 prices) .......... 57

Figure 31: Contribution to Cambodia’s GDP per industry of origin (at constant 2000 prices) ........................ 57

Figure 32: Cambodian Exports 2011 (in USD) .................................................................................................. 57

Figure 33: Garment and Shoes export division, 2011(in USD)19 ...................................................................... 57




List of Tables

Table 1: Acronyms Used in the study ................................................................................................................. 7

Table 2: Reasons for Sick Leave in 2006 ........................................................................................................... 15

Table 3: Cost of meal allowances or subsidies per year ................................................................................... 41

Table 4: Case Study: Food at Work ................................................................................................................. 43

Table 5: The Need for Real Case Studies .......................................................................................................... 47

Table 6: Specific recommendations for canteen models ................................................................................. 50

Table 7: General assumptions for the different scenarios ............................................................................... 52

Table 8: General assumptions on cost of eating scenarios .............................................................................. 53

Table 9: Typical income and expenses according to the Workers’ Rights Consortium ................................... 53

Table 10: Caloric intake of workers’ (especially when living in Phnom Penh) ................................................. 54

Table 11: Key economic indicators in relation to the cost of a workers’ meal ................................................ 55

Table 14: Briefing on Typhoid .......................................................................................................................... 56

List of Photos

Photo 1: Cover - Outside the factory gate, where the workers eat (Courtesy of SHRM&P Cambodia) ............ 3

Photo 2: Garment factory worker purchasing a sweet drink (Courtesy of SHRMP) ........................................ 12

Photo 3: Getting ready for work: Food and snacks outside the factory gate (Courtesy of SHRM&P) ............. 29

Photo 4: Workers swarm to purchase meals, snacks and goods (Courtesy of SHRM&P) ................................ 30

Photo 5: Cambodian snacks (Courtesy of HRINC (Cambodia) .......................................................................... 30

Photo 6: A typical scene "Outside the factory gate" (Courtesy of SHRM&P) .................................................. 32

Photo 7: A typical scene "A worker buying a snack, outside the factory gate" (Courtesy of SHRM&P) .......... 34

Photo 8: Facilities in action (Courtesy of HCFM Website) ............................................................................... 38




Acronyms Used in the Study

Table 1: Acronyms Used in the study

Acronym Detail

BFC Better Factories Cambodia

CDHS Cambodia Demographic and Health Survey

CMT Cut Make Trim

DGH Directorate General for Health

GMAC Garment Manufacturers Association in Cambodia

HCFM HAGAR Catering and Facilities Management

ILO International Labour Organisation

KHR Khmer Riel

L Litres

LHS Left Hand Side

RHS Right Hand Side

SHRM&P Society of Human Resource Management and Productivity

USD United States Dollars




Executive Summary

This study focussed on a review of the perceptions of factory managers, all member of the Garment

Manufacturers Association in Cambodia (GMAC) also including some footwear factories, on health and

nutrition. It attempts to understand the feasibility of setting up canteens for the garment sector or

individual factories where facilities and space allow for HAGAR Catering and Facilities Management (HCFM)

a social enterprise offering catering and canteen services (among others).

The study was conducted over the busiest production period for the garment and footwear sector, during

November and December of 2011. In total, 27 factories participated in the study employing approximately

34,939 workers, approximately ten per cent of total workforce of the garment (and footwear) sector. 90%

or more of workers are female. Factory sizes represented in the survey are evenly distributed between

smaller and larger factories. Overall the sample size can be characterized as representative of the sector.

The garment (and footwear) industry in Cambodia is an important sector – economically and

socially: It generates a significant amount of formal employment, over 300,000 jobs per year amongst

approximately 315 factories. It accounts for a significant proportion of GDP. Recent fainting incidents in the

sector in 2011 have highlighted once again the need to address the health of workers in general. Lack of

nutrition, unhygienic nutrition, lack of information as well as factory conditions and mass hysteria have

been mentioned as possible contributing factors to the fainting incidents. Numerous discussions were held

around the fainting incidents and concerns reached the highest levels of government. As a result, in the last

Government-Private Sector Forum, it was decided that all factories would provide a five dollar health

allowance or subsidy to workers which is being implemented in 2012. This increase alone is estimated to

contribute an additional 18 million to the Cambodian economy every year or 1.5 million every month1.

Various studies conducted in other garment manufacturing countries around the world provide useful

inputs into the challenges around nutrition and canteen facilities. Studies on this in Cambodia are scarce

and the most significant report on nutrition and health is the ‘Women and Work in the garment industry’

by the ILO & World Bank in 20062.

Cambodia health data confirms that one in five (19%) Cambodian women are too thin and more than 4 in

10 women in Cambodia are anaemic, although moderate and severe anaemia is relatively rare (8%) and

Anaemia in women continues to decrease, from 58% in 2000 and 47% in 20053.

This study was not conducted in response to fainting in factories. Rather, it is a strategic study that

attempts to review perceptions and opportunities for providing professional canteen services to the

industry with the objective of improving the health of workers through nutritious food as well as

improving productivity while doing so.

Study findings show that:

Almost 90% of responding factories are concerned about health challenges related to their employees.

More than 75% of factories provide at least basic medical care for their workers.

1HRINC Calculations: 5 dollars x 300,000 workers x 12 months

2‘Women and work in the garment industry’, page 9, 2006, ILO & World Bank

3The 2010 Cambodia Demographic and Health Survey (CDHS) conducted by the Directorate General for Health (DGH) of the Ministry

of Health and the National Institute of Statistics of the Ministry of Planning, page 13.




All factories provide drinking water.

Most factories do not have a canteen or even eating areas for workers. Thirty three per cent of

factories did have an eating area, which could potentially be turned into a canteen (this is not based on

a technical assessment of the eating areas described).

Nutrition and personal care are important issues for management:

Factories are interested and want information to distribute to their staff. They are concerned about

nutrition and health.

Although skills remain the key challenge to productivity levels in factories, health, nutrition and

nutritional value is a concern and is recognised by factories as a key constraint to productivity.

Access to information and dissemination of information is recognised as important, not only on

nutrition issues but personal care as well.

Improving productivity and output, improving skills and maintaining current cost base and overheads

are very important to factories.

Respondents in general did not feel that a 10 hour working day is too much for a worker and they agree

that workers send too much money home and therefore do not have sufficient funds for themselves to

buy basic foods.

The majority of respondents feel that the choices workers make regarding what they eat, is their

personal responsibility. On the other hand, the majority of companies (>50%) agree the companies

should be involved in the challenges related to nutrition and personal care.

Workers do not eat healthy meals and should have access to more hygienic and clean food

services:

Although 33% thought that their workers eat healthy meals, most respondents remained neutral as to

whether or not they would personally eat the food outside the factory gate.

Workers need better access to hygienic and clean food services, whether those are provided by private

or public service providers.

Existing providers need to improve hygiene and cleanliness or be provided with appropriate facilities.

Management perceptions on cost of meals:

The more healthy meals account for about two third of the minimum wage. Seeking creative ways to be

thrifty with money, whether pooling resources to purchase collectively, bringing food from home (which

also has a cost), or purchasing poor quality products to be able to have more appear necessary for workers

to be able to manage their personal and family responsibilities, is a reality and necessity. Often being thrifty

comes at a cost of foregoing personal health such as skipping meals, or eating less, as research has shown.

Breakfast is generally eaten at home before work or nearby the factory before coming into work. Many

factory workers take lunch from home to the factory to save money. Overall 78 per cent of respondents

noted that workers purchase some food outside the factory gate. Unless workers are working overtime or

late, dinner is generally eaten at home. In the event that there is over time, an allowance is provided for

workers to eat.

The cost of providing a meal or subsidizing meals is the most critical factor to decision making.

Managers lack information around food services provision.




Only two factories in the survey had canteen facilities. While many would consider a canteen facility, it is

clear that information is needed, not only on who can provide the service, but the cost and the real impact

having a canteen will have. A canteen that provides low quality meals and does not demonstrate health or

productivity improvements for factories may have a negative impact on providers in the canteen services

sector.

Fifty six per cent of respondents would consider providing one meal to their workers. Cost is the main

factor for factories to consider providing a meal to workers. Impact on productivity or turnover as a reason

for subsidising meals was not as important as researchers thought it would be, however generally a key

concern for factories overall. Interestingly, snacks, which would assume less challenges as they don’t

require facilities to sit and eat, was not something the majority of respondents would consider, but

additional information on types of snacks (and the health benefits) and ease of handling might change the

views. Of those who would consider providing one meal, the majority would provide lunch followed by

breakfast.

The study was an initial attempt in understanding the perceptions of factory management on

nutrition and health and its impact on productivity. Factory management has an understanding of the

link between nutrition and productivity, but lacks concrete facts and figures to work with as well as easily

implementable solutions and full stakeholder participation.

Addressing challenges around nutrition and health in the garment sector is a concern to unions, factories,

government and buyers. Given a common starting point and shared concerns, the issues around nutrition

and health can be a topic that parties (buyers, unions, government, employers and workers) could tackle

together.

Some of the genuine challenges that need further work are:

There is a case for disseminating more information in general around personal care and nutrition.

Factories, unions, GMAC and buyers could do more in ensuring that workers are informed.

A need to address the issues around nutrition and health in a strategic and coordinated manner

bringing unions, government, employers and buyers to the table.

A need for more information on the costs associated with canteen services and how the introduction

of meals or subsidies has a return for employers as well as an insight into whether a meal subsidy will

simple be passed on to the cost of the product which might impact Cambodian competitiveness etc...

A need for more information to better understand the link between nutrition, health and productivity

and the tangible effects such as reduction in sick leave, more loyalty and commitment, lower turnover

of workers, but also the time lapse between better food and better productivity, etc.

A need for factories to better understand who the canteen facility management providers are.

A real apparent opportunity to pursue joint canteen facilities if a strategic coordination committee was

set up. But also a need for a more in-depth feasibility study as space is an issue

A need to improve the “business environment” outside the factory gate by improving hygiene and

cleanliness of service providers. This is mostly a public responsibility and will require standards, rules

and regulations to be set, even licensing of smaller providers or provision of public facilities where

entrepreneurs can sell their goods and services.




Background

Nutrition and the Cambodian garment sector

The garment industry employs over three hundred

thousand workers, predominantly female. Most of

these young women come from surrounding

provinces migrating to Phnom Penh, in search of

economic opportunities and employment. Many

studies have shown that a significant portion of the

earnings made in factories is remitted back home to

support families. The trickledown effect of how these

young female workers impact economic development

in the provinces has not yet been documented in any

detail, but it is substantial. However their ability to

spend thriftily and save money to send home to

family often comes at a cost to their personal health

and well-being.

The responsibilities that these young women carry, in

terms of financial support to often large families is

significant and very characteristic of how the younger

generation often migrates to Phnom Penh,

responsible for working, studying and earning an

income while also supporting aging parents and

growing younger siblings in their hometowns.

Recent fainting spells in the garment sector have

highlighted once again the need to address the health of workers in general. While not many in-depth

studies on the actual cause of fainting have been

conducted, malnutrition has been mentioned several

times as one of the contributors.Other challenges in

relation to the fainting incidents include unhealthy

eating habits, unhygienic facilities offering nutritious

food to workers around the factory area and general

lack of knowledge around health and nutrition as well

as lack of information and access to information being

constraints in helping workers understand and address

challenges.

It is worth noting that factory conditions varyeven

though all exporting factories are members of the

Garment Manufacturing Association of Cambodia

(GMAC) and are monitored by the ILO, Better Factories

Cambodia. Proper ventilation and factory ergonomics are also an area of concern relating to the mass

fainting spells that have occurred. Many factory owners have commented on the mass fainting hysteria

phenomena, where as a result of one person fainting for a real reason, everyone faints as a consequence.

Quick Facts on the Cambodian Garment

Industry

In 2011 USD 4.25 Billion worth of garments,

textiles and shoes were exported, while the

total export value for Cambodia was USD

4.98 Billion. 75% of Cambodian export was

garments, textiles and shoes. (Phnom Penh

Post 20-1-2012, information from MOC, GMAC)

There are 300 factories with exporting

licenses (as of Oct 2011); these factories

employed 345,000 workers of which 90%

women. Another estimated 200,000 workers

work in garment factories that supply

exporting factories but do not have export

licenses (Phnom Penh Post 7-2-2012, information

from BFC and MOC), BFC, 27th Synthesis report on

working conditions in Cambodia’s garment sector

Predominantly female workforces, 90% of

them are young women from Prey Veng, Svay

Rieng, Takeo, and Kampong Speu Provinces

migrating to Phnom Penh City. (Phnom Penh

Post 7-2-2012, information from BFC and MOC)

HE Mam Vannak, Secretary of State at the

Ministry of Labour and Vocational Training

regarding the mass fainting’s:

“No garment worker has died during group

fainting,” adding that for many, “a glass of

sugarcane juice” was enough to get them out

of the hospital and back to work. Vannak

estimated that about 60 per cent of the

fainting was “due to lack of nutrition”.

Workers were saving their earnings rather

than buying nutritious food. One step the

government was taking to solve this problem

was improving health education”.




Numerous discussions were held around the mass fainting incidents and concerns reached the highest

levels of government. As a result, in the last Government-Private Sector Forum, it was decided that all

factories would provide a five dollar health allowance or subsidy to workers which is being implemented in

2012. This increase alone is estimated to contribute an additional 18 million to the Cambodian economy

every year or 1.5 million every month4.

This study is intended to focus on reviewing the perceptions of factory managers (all members of

GMAC)on health and nutrition and it is not a consequence of the fainting incidents as such, but the

fainting is relevant as malnutrition is mentioned as one of the contributing factors. It attempts to

understand the feasibility of setting up canteens for the garment sector or individual factories where

facilities and space allow. The study reviews perceptions on creative solutions to address nutrition

challenges. At a broader level, the study hopes to provide Hagar Catering and Facilities Management

(HCFM), a leading social enterprise, with options and strategic input to pursue canteen facilities in

Cambodia’s leading sector of employment, the garment sector. Given this, it was worthwhile to review

previous work and studies relating to health and nutrition in general.

Nutritional status of women in Cambodia in general:The 2010 Cambodia Demographic and Health

Survey (CDHS) conducted by the Directorate General for Health (DGH) of the Ministry of Health and the

National Institute of Statistics of the Ministry of Planning review weight and height measurements of

women aged 15 – 49 and found the following facts5

One in five (19%) Cambodian women are too thin. The percentage of women who are too thin has

remained relatively stable since 2000.

More than 4 in 10 women in Cambodia are anaemic, although moderate and severe anaemia is however relatively rare (8%). Anaemia in women continues to decrease, from 58% in 2000 and 47% in 2005.

Another article and there are numerous on this subject, indicates the consequences of lack of nutrition,

with regards to reduction in

productivity: “Worldwide, billions of

people suffer from micronutrient

malnutrition: a “hidden hunger”

resulting from a lack of vitamins and

minerals that can increase

vulnerabilities to sickness, disease and

even death. These deficiencies, which

most people are unaware of, hamper

physical and cognitive development

and reduce productivity of entire

populations”6

Photo 2:Garment factory worker purchasing a sweet drink (Courtesy of SHRMP)

4HRINC Calculations: 5 dollars x 300,000 workers x 12 months

5The 2010 Cambodia Demographic and Health Survey (CDHS) conducted by the Directorate General for Health (DGH) of the Ministry

of Health and the National Institute of Statistics of the Ministry of Planning, page 13. 6Source: www.phnompenhpost.com/index.php/2011042948802/Special-Reports/ultra-rice-slips-nutrients-in-via-one-special-grain-

for-every-100-ordinary-grains-of-rice.htm




A potential solution to the lack of micronutrients is the joint project of the UN Programme for Food Security

and Nutrition in Cambodia under the Millennium Development Goals Fund (MDG-F), the National Nutrition

Programme of Ministry of Health, the Labour Departments of Kampong Speu and Svay Rieng, ILO and

WHO, to distribute Weekly Iron Folic Acid

Supplementation (WIFAS), targeting women at

reproductive age from 15 to 49 years old on the

grounds of helping to reduce the anaemic rate

among women, however the impact of this

project have not yet been released. 7

The most significant report on nutrition and

health is the ‘Women and Work in the garment

industry’ by the ILO & World Bank in 20068.

Although not very recent the issues that

emerged in the study are as relevant today, as

they were in 2006. Of the almost 1000 men and

women workers’ interviewed in 2006; the link

between better food and fewer sick leave days

is apparent. This serves as a compelling

argument around the need to review the

general health of workers to increase

productivity, a key constraint in the Cambodian

workforce in general. Workers with a better

nutritional status appeared to take less sick

leave days, furthermore there seemed to be a link between less sick leave and more often than not eating

in a factory, where workers ate more vegetables and meat in their meals.

The amount of money a worker spends on a meal: Information on spending patterns of Cambodian

garment workers’ appear regularly in the news, however comprehensive studies documenting trends are

not many.

Another report “Living wage survey for Cambodia’s Garment Industry”, 2009, by CIDS, showed that

interviewed garment workers’ spend a total of US$72 per month, of which US$57 (80%) is on their personal

basic needs and US$15 (20%) is on financial commitments to the family household. This is around US$57

per month or about US$1.84 per day for basic needs, below the NIS figure of $3 per day in Phnom Penh. Of

this amount, garment workers spend US$0.97 daily on food. This low spending is the result of extreme

7 The two provinces employ over 30,000 workers. In late 2011, Labour Department and Health Department of Kampong Speu

planned to distribute the WIFAS to 20,626 workers in six factories/enterprises while in Svay Rieng, the two departments have

planned to distribute WIFAS to 19,836 workers. The distribution of WIFAS took place from October 2011 to January 2012 to 73,306

workers with the average of 18,327 workers per month. The distribution was put on hold since the Health Centres and Ministry of

Health ran out of stock. Therefore, the distribution of WIFAS in Svay Rieng did not take place. Representative of Kampong Speu

Health Department revealed that UNICEF and Ministry of Health are working on the issue of purchasing more WIFAS and expect to

arrive in June or July 2012. CDHS. Cambodia Democraphic and Health Survey 2010. Preliminary Report, Phnom Penh: National

Statistic Institute (MoP) and General Directorate of Health (MoH), 2010 8‘Women and work in the garment industry’, page 9, 2006, ILO & World Bank

Although this example was posted during the

economic crisis, it is very relevant today. “Sitting

near a food vendor Phin Ron, 23, eats a meagre

lunch with her friends. “I spend only 1,000 Riel

(US$0.24) for a meal at any time, and I eat just

enough to keep hunger at bay," she said. "The

food I eat every day does not give me enough

energy, but I don't have money to buy good food

or eat in a restaurant. I don't want to waste

money on food, even though it's important for my

health. I have to save money for my family."

Many garment workers said the lack of nutrition in

their diets had left them exhausted, pale and

prone to illness. "Sometimes I get a headache and

become very tired when I work hard, I think it is

because I eat unhealthy food now."

Adopted from Phnom Penh Post, 7 May 2009




budgeting and thrifty spending by workers. Survey findings revealed that the way workers keep spending

on basic needs low is by eating and living in groups and by minimising food expenses by bringing food

from their village.9

Figure 1: Monthly Expenditure on food for garment workers

Source: Living wage survey for Cambodia’s Garment Industry”, 2009, by CIDS

Sick leave in factories: The ILO and World Bank “Women and Work in the garment Industry” study

identified that “In factories that have a canteen, workers seem to eat more meat and more vegetables and

the sick leave for a factory with a canteen seems significantly lower”.

Figure 2: Relationship between sick leave, nutritional meals and factory canteens

Source: ‘Women and work in the garment industry’, page 9, 2006, ILO & World Bank

Reasons for sick leave: Typhoid was being identified by managers as the main reason for workers taking

sick leave. Typhoid is caused by contaminated water – the directions to prevent Typhoid are directly linked

to the places where workers live and eat: contaminated drinking water, not enough hand washing, unsafe

iced drinks, eat foods that are thoroughly cooked and are still hot and steaming, avoid already peeled and

cut vegetables and fruit. The main approach to get rid of Typhoid is food related as well. If Typhoid is not

treated properly, it will return regularly. The main symptoms are fever, weakness and diarrhoea.

9CIDS | Living Wage Survey for Cambodia’s Garment Industry, page 6-15, February 2009, by Dr. Kang Chandararot, Liv Dannet,

Prepared by the Cambodia Institute of Development Study, Financed by the Friedrich Ebert Stiftung, In Cooperation with TWARO-

ITGLWF (CIDS = The Cambodia Institute for Development Studies)




Table 2: Reasons for Sick Leave in 2006

Workers mentioned Managers Identified the following

Reason for taking sick leave Workers reasons for taking sick leave

Most time lost for sick leave per worker:

1. Fever 1. Typhoid 1. Typhoid

2. Feeling faint/dizzy/unconscious 2. Diarrhoea 2. Traffic accidents

3. Diarrhoea 3. Feeling faint/dizzy/unconscious

3. Fevers

4. Respiratory / urinary / reproductive

4. Fever 4. Diarrhoea

Source: ‘Women and work in the garment industry’, page 8, 2006, ILO &the World Bank

The Food for Work report, by the ILO, concludes the impact of poor nutrition on the national productivity

as follows.

Figure 3: The cycle of poor nutrition and low national productivity

Source: FOOD AT WORK10

10

FOOD AT WORK - WORKPLACE SOLUTIONS FOR MALNUTRITION, OBESITY AND CHRONIC DISEASES, p42, by Christopher Wanjek,

Copyright © International Labour Organization 2005

Poor health

Lack of energy,

Loss of strength,

Loss of coordination,

Lower learning potential

Poor quality job pool

Loss of competitiveness

Higher business costs,

Lower investment,

Lower economic growth

Lower wages,

Greater wealth disparity

Poor nutrition

The cycle of poor nutrition

andlow national

productivity




Is there a case for more canteens? Although there is an apparent link nutrition and productivity, and

between factories having a canteen (as a solution) and the a decreased amount of sick leave of workers

(productivity); in the ‘Women and work in the garment industry’ report and thus the case for a ‘canteen

solution’, the report also identified the following reasons why factories were reluctant to invest in a

canteen.

A number of these reasons are still resonating among factory respondents to the survey as well as

mentioned by the union representatives that were interviewed for the survey. Challenges mentioned in the

‘Women and work in the garment industry’ report were:

“Managers in one of the focus groups explained some of the difficulties they saw to establishing a canteen.

They worried that providing food would leave them11:

Liable to complaints from workers in the case of food poisoning

Believed that workers would interpret the establishment of a canteen as an attempt by the company to

make money from them.

The price of running a canteen – because running a canteen would require outside expertise, they

believed that the costs would outweigh the benefits, despite recognising the probable positive effects on

worker nutrition and sick leave.”

It is worth mentioning that our interviews with unions indicated that there are significantly fewer canteens

today than there were a few years ago. Many canteens stopped operating; the reasons for the

discontinuation of canteen services were unknown by the union representatives, but could well be related

to the above challenges.

11Source: Women and work in the garment industry, page 9, 2006, ILO & World Bank




Study objectives and purpose of study

HAGAR Catering and Facilities Management (HCFM12) is a social enterprise with a partnership between

Hagar Social Enterprise Group (HSEG) and private investors from international catering businesses. HCFM

provides employment opportunities for men and women from Hagar NGO’s shelters and social programs.

HCFM is committed to raising employers’ awareness of nutrition issues to support the provision of

quality canteen meals in factories, to improve workers’ wellbeing and factory productivity. To this end,

HCFM partnered with various stakeholders, including private sector, to conduct a survey of industry

practices for the provision of workers’ meals in the garment and footwear industry in Cambodia.

More broadly, this study is intended to focus the perceptions of factory managers around health and

nutrition. Factories that were pursued are all members of the Garment Manufacturers Association in

Cambodia (GMAC) which means, exporting factories in Cambodia. The study also attempts to understand

the feasibility of setting up canteens for the garment sector or individual factories where facilities and

space allow. In addition, the study looks at creative solutions to address nutrition challenges and the

feasibility of such solutions.

Methodology & Approach

The team used a structured approach to the project consisting of four distinct phases. A structured

questionnaire was used to interview factories and collect data. Several expert interviews were conducted

including meeting with unions and industry representatives. The report has been reviewed by a number of

stakeholders. The project approach is presented in the figure below.

Figure 4:Project Approach

Questionnaire design & literature review: The questionnaire was designed by HRINC and BDLINK

(Cambodia). The questionnaire was provided to HCFM and relevant stakeholders for review and input

before finalising and translating into Khmer and Chinese. A literature review was conducted to provide

inputs into the questionnaire and design. The questionnaire consisted of mainly multiple choice questions.

Questionnaire implementation: The sample size outlined for the project is to capture the feedback of at

least 30 factories, representing approximately 10% of the industry, in terms of number of factories. Survey

implementation was conducted at the end of 2011 and took around 2 months. The GMAC membership list

was used as a first tool and GMAC emailed members to make them aware of the survey. The GMAC

12See HCFM website for more information

Questionnaire Design & Literature

Review

Survey Implementation & Interviewing

Data Consolidation &

AnalysisReport Writing




database includes garment and footwear manufactures, both manufacturing categories were included in

the survey as canteen and nutrition challenges were deemed similar. Personalised emails in English, Khmer

or Chinese were sent to factory representatives to encourage them to join the survey. The survey team

emailed all factories and followed up with telephone calls to factories several times to establish contact and

discuss the survey. The team attempted to interview general managers where ever possible and at the

factory premises when possible (to allow for observations).

Figure 5: Summary of efforts to contact factories

Most of the interviews took place at the factory premises (59%) and the rest answered by email; the latter

were phoned to clarify any responses. In general, HR, Compliance & CSR representatives and

Administration personnel were responsible for filling out the surveys.

331

500

302

121

66

83

527

270

50

100

150

200

250

300

350

400

450

500

Total Emails Sent

Total Factories

Contacted (email)

Factories Called

Factory Responses

Final Results

Completed Surveys

Wanted to participate, no time

Several follow-ups, no response

Not Interested

# contact out of order




Figure 6: Interview venue and respondent profile

Survey Constraints

The survey was conducted over November and December 2011. This is the busiest time of the year for

factories making it challenging to meet General Managers. The GMAC membership database, available on

the GMAC website, is not up to date. This created challenges to identify the correct contact details for

factories.

Further constraints worth noting include the following:

1. Sixty six factories did not respond to the questionnaire however the team did in fact speak to

managers, after several attempts to identify the right person. Managers mentioned over the phone

that they were not interested in a canteen or in canteen services and that they did not want to fill in

the questionnaire. It was difficult to gage whether factories were “really not interested” or whether

the time of the year, the busiest time, also impacted on not wanting to take part in a survey.

2. No Space or Budget:Some of the above mentioned factories said that they did not have the space or

the budget for a canteen and therefore did not feel the survey was relevant to them, regardless of

explaining the objective to also gather perceptions on joint facilities.

3. Five factories who did want to participate in the survey, however, kept rescheduling the interview

dates and were finally too late to be included in the survey when the analysis and report writing phase

was reached.

4. General reluctance of factories to let outsiders into their factories or even to talk to outsiders

especially given recent challenges on fainting in the industry and the theme of the study.

5. Information requests for many factories are dealt with at headquarters outside of Cambodia and can

therefore easily be ignored.

Given the limited budget for implementing the survey, and the apparent interest in innovative ideas such

as joint facilities, it might be worth pursuing a more in-depth feasibility study on join facilities in the future.

37%

59%

4%

11%

44%

44%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Interview Venue (N=27) Respondent Profile (N=27)

Administration Peronnel (N=12)

HR, Compliance & CSR (N=12)

General Manager (N=3)

HRINC (N=1)

Factory (N=16)

Email (N=10)




Survey findings

1 Characteristics and profile of participating factories

Key characteristics of participating factories

Almost 90% of responding factories are concerned about health challenges in relation to their employees. Nutrition is regarded as a factor impacting productivity in factories and potentially lowering turnover. While factories seem concerned about health of workers, they do not feel the burden should be carried by the employer alone.

34,939 workers are employed amongst the 27 participating factories, which is approximately ten percent of the estimated total workforce of the garment factories registered with GMAC and the ILO Better Factories Cambodia. 80% or more of workers are female. Factory sizes represented in the survey are evenly distributed between smaller and larger factories. Overall the sample size can be characterized as representative of the sector.

There does not seem to be a relationship between the number of management and professional staff and the number of employees on the production floor, including supervisors.

Working hours are very characteristic of the garment sector, most factories working 8 hours with 2 hour overtime when required. 22 percent of factories worked 10 hours day, including the 2 hour overtime into a normal working day. There is no relationship between working hours and factory size.

More than 75% of factories provide at least basic medical care for their workers. Forty four per cent have a medical infirmary as the only provision of medical coverage, and at least 33% of factories provided private health care insurance.

All factories provide drinking water. The majority of factories have an in-house filtration system to filter water. Consumption levels vary significantly; it was not possible to draw conclusions from the current data.

Most factories we interviewed and almost all of the factories that did not want to participate in the survey did not have a canteen or even eating areas for workers. Thirty three percent of factories did have an eating area, which could eventually be turned into a canteen.




Concerned about employee health challenges:

Figure 7:Are you concerned about your employees’health

Almost 90% of responding factories are

concerned about their employees’ health. The

majority of factories we spoke to (almost 75%)

that filled in the questionnaire were registered

under Asian ownership including owners from

Cambodia, China, Korea, Malaysia, Taiwan and

Singapore (according to the GMAC data base on

their website). Only a quarter were from other

parts of the world including Spain and the USA.

Factories feel that they should be involved in

employee challenges related to nutrition and personal care. However they also feel that workers have to

take responsibility for what they eat. Employers do feel that workers send too much money home;

therefore they are unable to buy healthy food and support themselves. The challenges related to workers

migrating to Phnom Penh for economic and employment reasons particularly in the Cambodian context are

important to keep in mind however. Workers are not only looking after their own well-being, most also

need to support their extended family and as such and the challenges back home also have a real impact on

their life and their wellbeing in the city. Respondents are also in agreement that nutrition impacts

productivity and that nutrition is one of the main constraints to better productivity (and potentially less

turnover of workers) levels in the factory.

Respondents are concerned about the health and safety challenges of their workforce and employees

however are clear that the burden cannot be put onto the employer alone.

Results are presented in Figure 8 on the following page.

Yes (N=24), 89

%

No (N=0), 0%

A little bit (N=3), 11

%




Figure 8:Perceptions on nutrition and responsibilities

4%

4%

11%

11%

15%

7%

7%

33%

7%

15%

15%

44%

44%

4%

26%

22%

41%

30%

44%

19%

37%

30%

63%

52%

52%

15%

70%

44%

41%

56%

4%

7%

30%

11%

15%

30%

19%

11%

4%

4%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Skills are the main constraint to productivity levels in my factory

Nutrition impacts productivity

Nutrition is the main constraint to productivity levels in my factory

10 hours per day is too much time for the workers to be working

If workers eat healthier food, they would be stronger

Workers send too much money home, so they cannot buy the basic food to keep them healthy

Workers eat unhealthy food

What workers eat, is the worker responsibility

Companies should not be involved in challenges related to personal care

Companies should not be involved in the challenges related to nutrition

Completely Disagree Disagree Neither agree nor disagree Agree Completely Agree




Employee composition & factory size: Factories represented in this survey employ 34,939 workers in

total, and account for approximately 10 per cent of the total workforce in the garment sector. Ninety-

eightper cent of the workforce works on the production floor and the remaining staff, management and

professional staff13. Factory sizes are fairly representative of the sector including very large factories

employing more than 2000 workers. The biggest factory employed just over 4000 workers. The smallest

factories employ less than 500 workers with the smallest factory employing just fewer than 250 workers. A

typical garment factory in Cambodia has around 800 workers. As expected, woman workers represent 80%

and more of the workforce, especially on the production floor. The findings are presented in Figure below

While not a result that impacts the overall findings of the study related to nutrition, it is interesting to see

that there does not seem to be a relationship between the number of workers on the production floor

which includes supervisors, and management and professional staff. It is worth reviewing the relationship

between professional and management staff in a factory as this provides some insights into the

management capacity and ability to deal with emerging challenges in a factory. The findings are presented

in Figure 9 below.

Figure 9: Employee composition and strength

Daily working hours: While no studies exist on relationship between the number of work hours and

nutrition in Cambodia, the number of hours spent is an indicator of how much time is left in the day for

‘other’ activities such as rest and relaxation – an important factor to ensure overall health. Workers that

live in the country side will on top of the working hours also need to travel home, while the travel time

might not be much, the waiting for the truck to fill up as well as the standing during the trip are exhausting,

but then workers could come home to a cooked meal by other extended family members’. While workers

in Phnom Penh, do not have to travel far, but are responsible for cooking their own meals.

13 Professional staff represents administration and HR positions.

98%

19%

33%

26%

22%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Employee breakdown (N=27) Factory Size by Employee Strength (N=27)

2000<5000 employees (N=6)




Total Production Floor & Supervisors

Total Professional & Management




Figure 10: Working hours in the factory

It is common in the garment sector that factories

work 8 hours per day with additional two hours

overtime. Overtime is an important source of

income for workers. The survey results are

consistent with general practise in industry. The

majority factories (70 percent) generally work eight

hours per day and when needed, additional

overtime is requested. Six factories consistently

worked 10 hours per day including the standard 2

hour over time allowance in normal working time.

One factory had a standard working time of 12 hours a day. Shift work was not discussed with the factory as

to whether or not workers are working 12 hours per day or whether shift work occurs in this instance.

Working hours generally correlate with the number of orders and capacity of the factory to fulfil the orders.

We did review if there was a relationship between factory size and working hours but there was no clear

relationship. (See Annex)

ILO Better Factories Cambodia mentioned that the compliance rate on ‘limits to 2-hour overtime14 per day’

is very low with the average of 29% (from 35% and 27% in 2010, the 24th Synthesis Report) and 25% in

early 2011 (26th Synthesis Report). The lowest compliance point in the graph below is 18% on excessive

overtime in 21st Synthesis Report produced in October 2008 right before the global financial crisis. The

worst compliance rate of exceptional overtime provision is 10% of the factories, monitored through 17th to

27th Synthesis Reports. Better Factories Cambodia monitored 288 factories in 2010 and 355 factories in

2011 according to the four synthesis reports produced in the past two years.

Figure 11: BFC Synthesis reports on exceptional overtime and 2-hour limit

14 Labour Code Article 139 states that if workers are required to work overtime for exceptional and urgent jobs, the overtime hours

shall be paid at a rate of fifty percent higher than normal hours. If the overtime hours are worked at night or during weekly time

off, the rate of increase shall be one hundred percent. Article 140 of Labour Code limits hours of work not more than ten hours per

day.

7.5 hours (N=1), 4%

8 hours (N=19), 7

0%

10 hours (N=6), 22

%

12 hours (N=1), 4%

0%

10%

20%

30%

40%

50%

60%

20th SR 21st SR 22nd SR 23rd SR 24th SR 25th SR 26th SR 27th SR

% o

f fa

cto

ries

in C

om

plia

nce

Exceptional OT OT limited to 2hrs/day




The provision of medical care: The questionnaire reviewed whether or not factories have medical plans

for their workers which could be seen as a possible indicator of “increased concern for workers”. In

particular, the use of SKY insurance, an insurance scheme designed especially for poor households and

introduced to the garment sector as an option for health insurance.

Six respondents did not answer this question. None of the respondents in this survey used SKY insurance

for their workers. Forty four per cent of factories have an in-house infirmary and a third of the

participants provide private medical insurance. Factories provided additional information as to their

insurance coverage.

Three factories provided private health insurances which include a medical plan and private work

place accident coverage.

Nine factories provided a private work place accident policy in addition to the National Social

Security Fund

One factory had a committee that focussed on work issues, and they managed a budget of USD250

per worker in case of any emergency need.

Figure 12: Insurance provisions by factories

The provision of water to workers: Water is an essential part of every diet and the questions relating to

the provision of water attempt to understand the type of facilities used to provide fresh and clean water, as

well as understand the consumption levels of water in the industry. Prakas 054/00 requires employers to

provide enough safe drinking water for the employees working in their enterprise.

All factories provide water to their workers. Around 56 per cent of factories have in-house filtration

apparatus and the rest of respondents purchase branded water from the market.

Consumption in litres per month varies significantly. Around 30% of factories consume more than 10,000

litres per month. Data is insufficient to draw conclusions around the relationship between size of factory

and consumption and spending on water.

Sky Insurance Provision (N=0), 0%

Private Medical

Insurance (N=9), 33%

Only inhouse Infirmary

(N=12), 44%

No Response (N=6), 22%




Figure 13: Characteristics of water provision, consumption and cost

Existing canteen facilities: Most factories that were interviewed as well as the factories that we had

phone contact with did not have a canteen or even eating areas for workers.

Unions we spoke to mentioned that canteens had been more available in the past but that over the last

years the number of factories with canteens had diminished to less than one per cent of the factories

according to their calculations15.

Survey results show that 30 per cent of factories have an area that could be used as a canteen facility in the

future, although this is not based on a feasibility assessment of these areas. Four factories plan to set up

canteen facilities in the future. Of the 33 per cent of factories (9 factories) that have canteens, 7 of the

factories use these facilities for management staff only.

Figure 14: Existing Canteen Facilities in Factories and Opportunities to Pursue Canteens

15Union Federation Independent and Democracy,President &Workers Union Federation, President

Filtered In house,56%

Branded Water,44%

Unknown ,37%

22%

4%7%

7%

15%

4%4%

Unknown,41%

<USD1,000,33%

USD1,000<USD5,000, 11%

>USD5,000,15%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Type of Drinking Water (N=27)

Litres Consumed per month (N=27)

Monthly Drinking Water Bill in USD per month (N=27)

>100 thousand

25,000 <30,000

20,000<25,000

10,000<15,000

8,000<10,000

2,000<3,000

<2,000

2

78

10

0

2

4

6

8

10

12

The factory has an operational canteen for all workers and management

staff

The factory has an operational canteen for

(foreign) management staff only

The factory has no canteen but they have an eating

space - which could be used as a canteen eventually

The factory has no canteen




2 Is nutrition important? Management perceptions

It is clear that nutrition and health concerns are important to factory managers. In our discussions with

respondents most mentioned that there needs to be better information dissemination and support

(regarding health and personal care) to the industry to really increase impact. For example, unions we

interviewed spoke about being provided with information that could be disseminated but not enough

pieces are provided. There are few lessons to be drawn from our discussions with factory managers and

union representatives and these include:

Better coordination and cooperation between management and unions in factory, could in fact

achieve great results. Nutrition is a topic of common concerns to unions, government and factories.

Paper distribution is difficult and often, donors or supporting agencies are not providing sufficient

information for members, only key union representatives. Dissemination stops there. For example, if

there is only sufficient information to provide to some shop stewards, dissemination to other workers

will therefore be limited.


nutrition and health. GMAC could play a more important role in training, and assisting members to

understand how to disseminate information. For example:“We tell workers about….” Is a common

statement. Telling workers only lasts for 5 minutes, it is as important to reinforce learning and

management programs throughout the factory, visually, with practical posters that remind people of

what they have been told. Information leaflets in bathrooms, notice boards in public places or where

vehicles are parked or where workers gather.

Government should also be more involved in nutrition and health issues. Public programs on the

radio or TV could prove to be effective if designed in a manner that is appealing to these young people

and their families.

The perceptions of factories around nutrition and health issues are important to understand before reading

the remaining results of the study. Respondents were provided 13 statements which they ranked from not

at all important, to very important. The objective of these statements is to understand the perceptions of

the industry on key issues that impact factory success and worker health. Results have been grouped into

two separate charts. The first looks at perceptions around nutrition and health, access to information and

dissemination of information. The second looks at the importance of costs, skills, productivity and turnover

of workers.

How important is nutrition, access to information and dissemination of information: For the

overwhelming majority, all these issues are very important or extremely important. The results show that it

is not only the health of workers that is a concern, but also the nutritional values of what workers eat.

Access to information and dissemination of information is also very important, not only on nutrition issues

but personal care as well. In the local context, it is important that industry associations play a lead role in

facilitating information access, how to disseminate information. Disseminating information is not only

about giving in the appropriate format for the target audience, but re-enforcing messages constantly and

consistently to ensure that messages and information are received and internalised. Findings are presented

in the Figures below.

The importance of costs, productivity and skills: Improving productivity and improving output,

improving skills, decreasing turnover and maintaining current cost base and overheads are very

important to factories. The recent introduction of the health allowances (USD5 per month) are a key




challenge or indicator to watch and maintain. As many factories have said throughout the survey, “it

depends on the cost and the results “as costs are a key challenge. To encourage canteen facility set up,

whether for a factory or for an industry, will require significant effort to demonstrate the return on the

investment.

Figure 15:How important are nutrition and health challenges to factories?

Figure 16:The importance of costs, productivity & skills

26%

15%

26%

7%

15%

4%

59%

63%

56%

70%

56%

59%

11%

22%

19%

19%

26%

37%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Disseminating information to workers on personal care is…

Disseminating information to workers on health topics…

Getting information on personal care…

Getting information on different health topics is…

The nutritional value of food that workers eat is a concern to us

The health of workers is a concern to us

Not at all important Slightly important Moderately Important Very important Extremely Important

7%

26%

22%

7%

56%

56%

30%

44%

33%

56%

33%

44%

37%

44%

30%

59%

44%

67%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Ensuring we keep low overhead cost is …

Ensuring we maintain our current cost base is…

Finding skilled workers is…

Maintaining a low turnover of workers on the factory floor is…

Maintaining high productivity and output is ….

Skills development and training is …

Improving productivity and output is …

Not at all important Slightly important Moderately Important Very important Extremely Important




3 Management perceptions on workers’ meals and cost of meals

Key Findings

Perceptions on meals

It is worth noting that when we conducted this part of the survey, upon reflection, many of the respondents commented that they had not thought about how much workers spend on their meals before.

Unions mentioned the poor quality of food that people purchase, often old and not fresh.

Perceptions on the cost of workers’ meals

Most respondents perceive breakfast to be the cheapest meal of the day. Fifty four percent of respondents feel that workers purchase breakfast for less than KHR1500.

Lunch and Dinner are viewed as more expensive meals by at least 45 percent of respondents. These meals cost between KHR1500 and less than KHR2000. Around 45 percent of respondents also felt that dinner costs at least KHR2000 or more.

Seeking creative ways to be thrifty with money, whether pooling resources to purchase collectively, bringing food from home (which also has a cost), or purchasing poor quality products to be able to have more appear necessary for workers to be able to manage their personal and family responsibilities, is a reality and necessity, not a luxury that workers pursue. Often being thrifty comes at a cost of foregoing personal health such as skipping meals, or eating less, as research has shown.

Photo 3: Getting ready for work: Food and snacks outside the factory gate (Courtesy of SHRM&P)




3.1 Where workers eat: Management views

Photo 4:Workers swarm to purchase meals, snacks and goods (Courtesy of SHRM&P)

Breakfast: The respondents’ perceptions are

that workers generally eat breakfast at home or

nearby the factory on their way to work, only

few eat their breakfast at the factory. Other

comments included one factory giving bread to

workers for breakfast meals. One factory

mentioned that 20% - 30% of their workers bring

breakfast into the factory and eat at the factory.

Lunch: Seventy three per cent of respondents’

noted that workers bring their own lunch from

home and ate at the factory. If workers did not bring lunch from home, they often bought food outside the

factory gate and ate in the factory facilities. This comment is also echoed by discussions with a union

representative who mentioned that workers generally try to save as much money as possible and hence

bring their own lunch to work. During lunch time they might buy a small side dish to go with their lunch

outside the factory. Especially when workers live in their hometown with family they will bring their own

food as that is considered much cheaper.

Of the two factories with canteen facilities, not all workers made use of the facilities. In one factory, only

50% of workers eat in their canteen while the other group goes home to eat lunch.

Dinner: Most respondents replied that normally workers go home for dinner, except when they work

overtime. When workers are doing overtime work 50% respondents mentioned that an amount between

KHR2000-KHR2300 is paid for overtime dinner in cash to the workers. Typically in such a situation workers

would go outside the factory to buy the food and eat dinner in the factory because of limited time before

starting work, but also because of safety at night.

Snacks: The respondents were asked if they ever see the workers eat snacks, from a point of view of

potentially providing energy boosts during working hours. Fifty four per cent of respondents mentioned

they never see employees eating snacks. Around 30% of the respondents see workers eat snacks,

especially when the workers take a break.

Photo 5: Cambodian snacks (Courtesy of HRINC (Cambodia)




3.2 Management views on the cost of meals Respondents were asked what amount of money they thought workers spent on each of the 3 meals per

day. The answers were given in relation to buying food and not eating at home. For example for dinner

many respondents mentioned that workers generally eat at home as a group and do not spend that much,

but when they work overtime they would spend around KHR2000. Lunch and dinner are clearly more

expensive than breakfast according to perceptions of respondents. The majority of respondents feel that

breakfast costs less than KHR1500, fewer respondents feel that lunch and dinner can cost the same

amount.

54% believe that workers spend less than KHR1500 on breakfast.

Only 19% believe that workers spend less than KHR1500 on lunch, the rest believe workers spend

more and only 10% believe that workers spend less than KHR1500 on dinner

Figure 17: Management perceptions on the cost of meals

27%

4% 0%

17%

27%

19%

10%

24%

31%

44%

45%

35%

15%

33%45%

24%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Breakfast (N=26) Lunch (N=27) Dinner (N=20) Total (N=25)

2000+

1500<2000

1000<1500

Less than 1000 Riels




3.3 Outside the factory gate: Management perceptions

This part of the questionnaire is designed to understand management perceptions on (1) the healthiness of

workers meals and (2) the food service industry outside and around the factories. Statements were

presented to the respondent to which they had to Completely Disagree of Completely Agree on a classic 5

point Likert scale.

Photo 6: A typical scene "Outside the factory gate" (Courtesy of SHRM&P)

Do workers eat healthy meals? Thirty three per cent of respondents agreed that workers eat healthy

meals. All other respondents (67%) remained neutral (neither agree nor disagree) or disagreed with the

statement. Almost all of these factories do not have canteens; therefore workers are all eating outside

the factory gate. One factory with a canteen felt that their workers were not eating healthy meals.

Interestingly around 45% of respondents felt that food provided by vendors was healthy enough and they

would eat it themselves.

Workers should have better access to public or private eating facilities: Seventy per cent of

respondents agreed that workers should have better access to eating facilities, whether provided by public

or private sector. In addition 95 per cent agreed that vendors need to improve hygiene standards. The

majority of respondents all agreed that vendors should be provided with cleaner public facilities to serve

their food and should not be selling out in the open.

Cooked meals: Should vendors provide them or not? This statement was created to understand

whether or not factories feel that cooked food should not be provided by street vendors, especially if

hygiene and cleanliness are a challenge overall in the local context. Thirty three per cent of respondents

agreed that there should be no cooking on the streets. The remaining respondents are mostly neutral or

disagree (11%). For obvious reasons, it would cause more damage to workers and their general wellbeing if

all of a sudden; workers were unable to purchase cooked food close to the factory. Improving overall




quality of what is on offer, is important and calls for public services or innovative private services to

improve quality of food services.

Fruits and snacks: There was a mixed response as to the cleanliness and hygiene around selling of fruits

and snacks. Generally in its natural form fruits are seen as clean but when they are peeled or prepared

respondents feel that they are less hygienic. This question very much depended for respondents as to

whether or not fruit was prepared and ready to eat, or simply bought in its natural form. In general and in

line with the above, respondents felt that hygiene, cleanliness and better facility provision to food

vendors is important.

Figure 18:Perceptions on outside the factory gate16

16Statements regarding vendors are phrased as “vendors outside my factory gate”.For presentation purposes the phrases have

been simplified

15%

4%

22%

4%

11%

30%

48%

22%

33%

15%

15%

11%

56%

33%

33%

63%

33%

63%

74%

74%

33%

33%

7%

11%

22%

11%

11%

0% 20% 40% 60% 80% 100%

Our workers eat healthy meals

Our workers should have access to better eating facilities that are provided by the public or private sector

Vendors provide meals that I would consider healthy (i.e. I would eat them myself)

Vendors should improve hygiene standards

Vendors should be provided with cleaner public facilities to serve their food and produce

Vendors in general should not be selling in the open streets; they should be in hygienic facilities.

Cooked meals should not be served by vendors outside my factory gate

Fruits and snacks sold by vendors are generally clean and hygienic





4 The link between nutrition and productivity: What are the factories’

views?

This section of the survey reviewed perceptions of respondents on nutrition as an important factor

impacting on productivity. Respondents were provided with 15 statements and were asked to provide their

agreement on a five point scale, ranging from completely agree to completely disagree. The results are

broken into four sections:

1. What impacts productivity – is it skills only?

2. Working hours and their impact on productivity

3. Workers, their money and choices

4. Responsibilities

Key Findings:

Although skills remain the key concern in relation to productivity levels in factories, nutrition does play an important role and is recognized by factories as a key constraint to productivity. It is encouraging that respondents recognize the importance and link that nutrition has in improving productivity levels.

Respondents in general did not feel that a 10 hour working day is too much for a worker. Interestingly, respondents felt that workers were more productive after lunch.

Respondents agree that workers send too much money home and therefore do not have sufficient funds for themselves to buy basic foods. All respondents agree that if workers eat healthier food, they will be stronger; however, only 41% of respondents felt that workers eat unhealthy food.

The majority of respondents feel that the choices workers make regarding what they eat, is their personal responsibility. On the other hand, the majority of respondents(>50%) agree that factories should be involved in the challenges related to nutrition and personal care.

Photo 7:A typical scene "A worker buying a snack, outside the factory gate" (Courtesy of SHRM&P)




Does nutrition impact productivity? Yes! Although skills remain the key concern in relation to

productivity levels in factories, nutrition does play an important role and is recognised by factories as a key

constraint to productivity. It is encouraging that factories recognise the importance and the impact that

nutrition has in improving productivity levels. 65% and more of respondents agree or completely agree that

nutrition is a constraint or impacts productivity.

Figure 19:Does nutrition impact productivity?

Productivity, working hours and time: The objective of these statements is to understand at what

times of the day workers are less productive and whether or not a 10 hour work day is too much for a

worker in general.

Forty four per cent of factories disagree that a 10 hour work day is too much, while 41% of respondents did

not have an opinion. In general, workers want to work 10 hours, as the 2 hour overtime they receive is an

important source of income. Only 15% of respondents felt that a 10 hour working day is too much for

workers.

Interestingly, 52 % of respondents agreed that workers are more productive after lunch overall. Most

respondents did not feel there was a decline in productivity after lunch. Given that the respondents are not

productivity experts, the replies should be read with caution. However findings of work done by the Society

of Human Resource Management and Productivity (SHRM&P) shows a clear drop in productivity after

lunch, which might be a result of the type of food eaten.

4%

7%

7%

4%

26%

22%

63%

52%

52%

30%

11%

15%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Skills are the main constraint to productivity levels in my factory

Nutrition impacts productivity

Nutrition is the main constraint to productivity levels in my factory





Figure 20: Productivity and working hours and times

Workers, nutrition and responsibility: All respondents agreed that if workers eat healthier food, they

will be stronger. Only 41% of respondents agreed that workers eat healthy food. Sixty three per cent of

respondents felt that workers send too much money home and therefore are unable to buy the basic foods

necessary to keep them healthy. Respondents provided mixed responses on the knowledge their workers

have on nutrition, only 34% of respondents believe that workers do not know anything about nutrition,

almost 50% of respondents believe that workers do have knowledge on nutrition.

Figure 21: Workers and nutrition

11%

4%

7%

11%

33%

37%

48%

52%

15%

41%

37%

33%

26%

33%

15%

11%

4%

7%

52%

11%

7%

4%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

10 hours per day is too much time for the workers to be working

Workers are around 20% less productive after lunch



Workers are generally more productive after lunch


7% 41%

7%

15%

19%

30%

44%

70%

30%

44%

41%

30%

4%

19%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

If workers eat healthier food, they would be stronger

Workers don’t know anything about nutrition

Workers send too much money home, so they cannot buy the basic food to keep them healthy

Workers eat unhealthy food





The majority of respondents feel that the choices workers make regarding what they eat, is their personal

responsibility. On the other hand, the majority of respondents (>50%) agree that factories should be

involved in the challenges related to nutrition and personal care of workers.

Figure 22: Who is responsible?

Caloric intake per meal: No in-depth studies of worker food intake are known to be available, but

according to the “People's Tribunal on Asia Minimum Floor Wage Cambodia, Feb 2012, a presentation by

Mr. Bent Gehrt, Workers Rights Consortium”, the calorie count in a 500 Riel “Lunch”Soup (plus Rice) shows

a deficit of 161 calories while a typical Breakfast of rice and pork shows a deficit of 333 calories (see below).

The samples were analysed in the laboratory of the Ministry of Industry, Mining and Energy17.

LUNCH weight/

gram

# calories

/100gram

Total

calories

Calorie demand per day 2200

(2200/3=733 per meal)

Soup 200 76 152

Deficit of 161 Rice 250 168 420

TOTAL calories

572

BREAKFAST

Rice 200 168 336

Deficit of 333 Pork est. 50-60Kcal

60

TOTAL including some

vegetables 400

17Industrial Laboratory Center of Cambodia (ILCC)- The ILCC under the Ministry of Industry, Mines and Energy (MIME) has the main objective of

providing testing services for food analysis in support of the regulatory departments of MIME, food product safety and quality control systems,

standard activities, and other Non-Government customers (private sectors, NGO and community) for researching and improving their food product

quality and safety, Evaluation of Laboratory Capacities in Cambodia, March 2010, Klaus Ziller (FAO Consultant) for FAO Project MTF/CMB/032/STF.

11%

15%

15%

44%

44%

19%

37%

30%

56%

4%

7%

11%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

What workers eat, is the worker responsibility

Companies should not be involved in challenges related to personal care

Companies should not be involved in the challenges related to nutrition





5 Canteen facilities and how they operate

As presented in the profile section, only 2 factories have canteens for workers. One factory has their own

cooking staff preparing meals for workers and management, while the other factory has hired a Cambodian

private sector provider to prepare meals for workers. Both operate ‘buffet’ style systems, where rice is

more or less abundant and the rest such as soup and meat are limited to one portion per person.

Photo 8:Facilities in action (Courtesy of HCFM Website)

Factories that have a fully operational canteen: There are only two factories with canteens in the

respondents group that are cooking for both workers and for management. Both factories employ their

own cooks for the management canteen and one also has their own cooks for the production workers while

the other outsources the meals for the production workers to a private provider. One factory mentioned

that they pay 100% of the food for the workers as well as the management staff, while the other one only

provides the meals for free (as part of the benefits) to management staff.

Both factories with canteens did not provide answers to the costs of meals for production workers

question.

Factories that have a canteen space or an eating space: Only five factories responded to the

questions as to whether or not they consider contracting an outside agency for their canteen. Budget is the

biggest constraint for factories; some described the discussion as “very complicated”. Other constraints

include not allowing outside providers into the factory and respondents are not sure if they could trust

outside providers. There is a real need to build trust and credibility around canteen service provision.

Factories already face challenges around theft and maintaining facilities, without having to worry about

managing new facilities for which they are not responsible. One factory mentioned that they provide a

subsidy for workers of 500 Riel. Some feel that handing out cash is easier; however concerns do arise

around how the money is spent and whether or not it is genuinely spent on food.




Figure 23:Would you consider an outside service provider to run your canteen?

Factories with no canteen or eating space: Ten respondents answered this question. Respondents

from factories without a canteen or eating space mentioned that space and budget are the main

constraints they see to building a canteen. Comments from individual factories include:

Because we have to start paying a health allowance to the workers it would be unlikely that they would

invest in a canteen as well.

We would definitely build a canteen when we move to a new place; they have already discussed it in

the management team.

Even before the new health allowance, we had been subsidising the workers food, with 500 Riel per

lunch.

We have space but building a canteen would be on condition of the cost not being too high and clear

evidence that it will improve workers health.

We have a plan to do this, but at the moment we don’t have budget to implement

We may consider this.

It is also important to note that some factories mentioned that having a canteen is not general practise in

the industry therefore they do not see a reason to set one up. Others mentioned that they are not aware of

service providers who provide relevant canteen services.

Figure 24: Why do you not have a canteen?

There seems to be a lack of information

on:

What services are available for canteen

facilities

What is the positive impact of nutrition on

productivity and how would a canteen

address this.

What would be cost implications of a

canteen

How would canteen service providers

prevent food poisoning etc.?

Yes, if I don’t have to pay

anything (N=1), 20%

Yes, if the cost is reasonable

for what is provided

(N=2), 40%

Yes if it clearly improves

workers health (N=1), 20%

No, we don’t allow outside providers in the factory (N=1), 20%

We do not have space (N=4), 36%

We do not have

budget (N=6), 55%

We do not think this is important

enough (N=1), 9%




6 Subsidising meals for workers: An opportunity or not?

In this section of the survey we ask the factories whether or not they would consider paying for one, two or

three meals for workers or a snack in the early morning or afternoon.

Would you consider providing meals? As evident from the findings, factories are not likely to subsidise

more than one meal for workers. Cost is the main factor for factories to consider providing a meal to

workers. Impact on productivity or turnover as a reason for subsidising meals was not at all important to

these factories. Interestingly, snacks, which would assume less challenges as they don’t require facilities

to sit and eat, was not something the majority of respondents would consider, but it could be that snacks

such as a banana were not considered when thinking about snacks, while this could be a cheap and healthy

option. The majority of the factories that would consider providing one meal would choose lunch followed

by breakfast.

Clear case studies demonstrating the link between nutrition and increases in productivity, including

reduction in sick leave and absenteeism would be useful tools to make factory owners aware.

Figure 25:How many meals are you willing to pay for?

Pricing points: Participants were asked how much they would be willing to pay or subsidise for different

meals of the day if they used outside services such as HCFM to provide meals to their workers. The

question is hypothetical but attempts to understand factory pricing points on meals that they would find

affordable.

For most, the pricing point is less than KHR2000 for all meals. Around 15% of participants suggest between

KHR2000<KHR2500 for breakfast and lunch and around 19 % felt KHR2500<KHR3000 was a reasonable

pricing point for lunch. Dinner pricing points reflect only 15 factories so should be interpreted with caution.

Results are presented in the figure below.

56%

8% 11%

7%

4%

4%

8%

4%

4%

33%

79%

96%85%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 Meal (N=27) 2 Meal (N=24) 3 Meal (N=25) Snack (N=27)

No, it’s not an option that we will consider ever.

Only if I am convinced that productivity of the workers (increase) and turnover (decrease)

Only if I am convinced that productivity/output will increase

Yes, if the cost is reasonable




Figure 26:Willingness to pay for meals if provided by an outside provider

6.1 A cost scenario for providing meals or subsidies to workers

A cost scenario is developed to show the costs for factories in case they would want to subsidise a meal.

The overview attempts to provide insights and is not exhaustive in its analysis.

Assumptions used include:

26 days working per month (the reality is less due to numerous public holidays).

Different factory sizes are reviewed ranging from 800 up to 4000 employees.

Various subsidies per day are reviewed from KHR1000, KHR1500, KHR2000, KHR2500, and KHR3000.

The total cost per year for one employee seems small and achievable, however when multiplying the

numbers for large groups of employees the costs are significant.

Table 3:Cost of meal allowances or subsidies per year

Factory size Cost per year (KHR1000 per

day)

Cost per year (KHR1500 per

day)


day)

Cost per year (KHR2500 per day)


day)

1 $78 $117 $156 $195 $273

800 $62,400 $93,600 $124,800 $156,000 $218,400

1000 $78,000 $117,000 $156,000 $195,000 $273,000

1200 $93,600 $140,400 $187,200 $234,000 $327,600

1500 $117,000 $175,500 $234,000 $292,500 $409,500

1800 $140,400 $210,600 $280,800 $351,000 $491,400

2000 $156,000 $234,000 $312,000 $390,000 $546,000

3000 $234,000 $351,000 $468,000 $585,000 $819,000

4000 $312,000 $468,000 $624,000 $780,000 $1,092,000

72%

57%

73%

17%

14%

7%

6%

19% 7%

5%7%

6% 5% 7%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Breakfast (N=18) Lunch (N=21) Dinner (N=15)

12,000+

3000<3500

2500<3000

2000<2500

<2000




Factory owners will need well-defined proof of impact before considering investing in subsidising nutrition,

especially on top of the recent health allowance which is a $5 increase per workers per month already.

7 Opportunities:shared canteen service facilities

The idea of a joint facility is not a new concept; it is a relatively new concept for Cambodia. HRINC made a

recommendation for shared facilities for workers in 2005-6 when studying turnover challenges in the

sector. Although the study was factory specific at the time, recommendations were made to supporting

agencies. The idea of joint facilities is about sharing costs, reducing risks, and enabling workers to deal with

the day to day challenges they face in accessing clean and hygienic food. The shared facility can be as

simple as a food court that provides subsidized food and meals to those who are “members” of the facility

or work for an employer who is supporting the facility. Often such a facility includes government

participation and contributions for subsidised core foods such as rice. Nothing is provided for free, but at a

small mark up, to cover operating costs. This is especially feasible if there is financing and support for

infrastructure around the facility.

A joint facility for a canteen between several factories was generally not something that the respondents

had heard of before. Overall the respondents felt that this would be received well by all stakeholders in the

garment industry, however almost all mentioned that lack space would generally be an issue in the

existing garment factory areas. As the idea for a joint facility was rather new, this could have biased the

positive view of respondents on which stakeholders would contribute to this; a large percentage believe

that government, factory management, unions and buyers would contribute to the development of such

facilities. It is worthwhile investigating the feasibility of such a facility further, to relieve some of the

pressures on workers and wages.

Figure 27: Example of contributions from different stakeholders into a Joint Canteen

JOINT CANTEEN

FACTORY A = contribution could

be- subsidy for workers, % cost share canteen management…

FACTORY B = contribution could

be- subsidy for workers, % cost share canteen management…

UNION FEDERATION = could run their own

canteen as part of the benefit of being a

member, can join a canteen to work on awareness raising

BUYERS = as a CSR activity - subsidies for

workers through canteen tokens, CSR

projects, subsidize the building, information

provision

GOVERNMENT = contribution could be

land / building / space, nutritional

upgrading programme / tax

exemptions




Figure 28:Perceptions on joint canteen facilities

Table 4: Case Study: Food at Work

An example from: FOOD AT WORK18

The report mentioned in §4.22 that “The most successful canteens presented here owe their success to one or more of the following components: government participation; union participation; employer or employee enthusiasm; convenience; affordability; and healthiness. Thus, one take-home lesson is that while canteens might be commonplace, the canteens most valued by employees come through investment of will.”

Examples of stakeholders working together from the same report (§7.4) but with regards to improving street foods: “Street foods are widely popular among workers in Calcutta, particularly those in the informal sector who have no other food option. However, vendors have little knowledge of basic hygiene and illegal food additives, which jeopardize workers’ nutrition. A pilot study revealed that both the Government and vendors are willing to improve the situation: vendors agree to zoning; unions agree to training; and the Government agrees to infrastructure improvements, such as more rubbish bins and potable water sources, as well as low-interest loans. Health experts improved hygiene in the four study sites with creative training. The “Calcutta model” is now spreading to nearby cities.” A similar project was undertaken in Thailand, but here the government undertook the training.

18FOOD AT WORK - WORKPLACE SOLUTIONS FOR MALNUTRITION, OBESITY AND CHRONIC DISEASES, by Christopher Wanjek,

Copyright © International Labour Organization 2005

4%

7%

7%

7%

4%

11%

7%

19%

22%

19%

7%

56%

78%

67%

67%

59%

74%

33%

11%

7%

4%

15%

15%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Joint eating facilities in certain areas that have a better hygiene and cleanliness would be a good idea to …

Joint facilities would give the industry a good image of collaboration

Factories would be interested to contribute to infrastructure development of such a joint facility

Buyers would be interested to contribute to infrastructure development of such a joint facility

Unions would be interested to contribute to infrastructure development of such a joint facility

Government would be interested to contribute to infrastructure development of such a joint





8 Concluding remarks & recommendations

This study is intended to focus on a review of the perceptions of factory managers who are all members

of GMAC on health and nutrition. It attempts to understand the feasibility of setting up canteens for the

garment sector or individual factories where facilities and space allow for HCFM. The study was conducted

over the busiest production period for the garment sector, during November and December of 2011. In

total, 27 factories participated in the study employing approximately 34,939 workers, approximately ten

per cent of total workforce of the garment sector. 90% or more of workers are female. Factory sizes

represented in the survey are evenly distributed between smaller and larger factories. Overall the sample

size can be characterized as representative of the sector.

The garment industry in Cambodia is an important sector – economically and socially:

It generates a significant amount of formal employment, over 300,000 jobs per year amongst

approximately 315 factories. It accounts for a significant proportion of GDP. Recent fainting incidents in the

garment sector in 2011 have highlighted once again the need to address the health of workers in general.

Lack of nutrition has been mentioned as possibly one of the contributing factors, others include unhealthy

eating habits, unhygienic facilities offering nutritious food to workers around the factory area and general

lack of knowledge around health and nutrition, lack of information and of access to it are important

constraints in helping workers to understand and address challenges. It is worth noting that factory

conditions vary, although all exporting factories and members of the GMAC and are monitored by the ILO,

Better Factories Cambodia. Proper ventilation and factory ergonomics are also an area of concern relating

to the mass fainting that have occurred. Many factory owners have also commented on the mass fainting

hysteria phenomena, where as a result of one person fainting for a real reason, more faint as a

consequence of the first one fainting. Numerous discussions were held around the fainting incidents and

concerns reached the highest levels of government. As a result, in the last Government-Private Sector

Forum, it was decided that all factories would provide a five dollar health allowance or subsidy to workers

which is being implemented in 2012. This increase alone is estimated to contribute an additional 18 million

to the Cambodian economy every year or 1.5 million every month19.

This study was not conducted in response to fainting in factories rather; it is a strategic study that

attempts to review perceptions and opportunities for providing professional canteen services to the

industry with the objective of improving the health of workers through nutritious food as well as

improving productivity while doing so.

Various studies conducted in other garment manufacturing countries around the world provide useful

inputs into the challenges around nutrition and canteen facilities. Studies on this in Cambodia are scarce

and the most significant report on nutrition and health is the ‘Women and Work in the garment industry’ by

the ILO & World Bank in 200620.

19

HRINC Calculations: 5 dollars x 300,000 workers x 12 months 20

‘Women and work in the garment industry’, page 9, 2006, ILO & World Bank




Cambodia health data confirms that one in five (19%) Cambodian women are too thin and more than 4 in

10 women in Cambodia are anaemic, although moderate and severe anaemia is relatively rare (8%).

Anaemia in women continues to decrease, from 58% in 2000 and 47% in 200521.

The ILO and World Bank Study established an important link between the general health of workers and

productivity, both key constraints in the Cambodian workforce in general. Workers with a better nutritional

status appeared to take less sick leave days and these workers, more often than not, ate in a factory

canteen where they consumed more vegetables and meat in their meals. The study identified that “In

factories that have a canteen, workers seem to eat more meat and more vegetables and the sick leave in

factories with a canteen seemed significantly lower”. Typhoid is identified by managers and workers as the

main reason for workers taking sick leave. Typhoid is directly linked to unhygienic conditions in food and

water. The report also identifies challenges around canteens from management that remain relevant today.

These include concerns around quality of food, liabilities that the a factory would carry, perceptions of

workers that factories are trying to make money from workers if they have to pay for meals, and the cost of

running a canteen from establishment to professional management.

Study findings show that:

Almost 90% of responding factories are concerned about health challenges related to their

employees. Nutrition is regarded as an important factor impacting on productivity in factories. While

factories are concerned, they do not feel the burden should be carried by the employer alone.

More than 75% of factories provide at least basic medical care for their workers. At least 44% have a

medical infirmary as the only provision of medical coverage, and at least 33% of factories provided

private health care insurance.

All factories provide drinking water. The majority of factories have an in-house filtration system to filter

water. Consumption levels vary significantly and suggest doing further in-depth study to and review of

quality of water and individual consumption levels.

Most factories participating in the study and almost all of the factories that did not want to participate

in the survey do not have a canteen or even eating areas for workers. Thirty three per cent of factories

did have an eating area, which could potentially be turned into a canteen(this is not based on a

technical assessment of the eating areas described).

Nutrition and personal care are important issues for management:


nutrition and health. GMAC could play a more important role in training, and assisting members to

understand how to disseminate information. For unions and factories, disseminating information and

reinforcing learning is a challenge.

Although skills remain the key challenge to productivity levels in factories, nutrition does play an

important role and is recognized by factories as a key constraint to productivity. It is encouraging that

factories recognize the importance of health (and the nutritional status) of workers in relation to

improving productivity levels.

21The 2010 Cambodia Demographic and Health Survey (CDHS) conducted by the Directorate General for Health (DGH) of the

Ministry of Health and the National Institute of Statistics of the Ministry of Planning, page 13.




The results show that it is not only the health of workers that is a concern, but also the nutritional

value of what the workers eat.

Access to information and dissemination of information is also very important, not only on nutrition

issues but personal care as well. In the local context, it is important that industry associations play a

lead role in facilitating information access and how to disseminate information. Disseminating

information is not only about giving, but re-enforcing messages constantly and consistently to ensure

that messages and information are received and internalised.

Improving productivity and output, improving skills and maintaining current cost base and overheads

are very important to factories. With the recent additional health allowance (USD5 per month) that is

required to be provided to workers in the light of factory fainting, costs are a key challenge or indicator

to watch and maintain. As many factories have said throughout the survey, “it depends on the cost and

the results”. To encourage canteen facility set up, whether for a factory or for an industry, will require

significant effort to demonstrate the return on investment.

Respondents in general did not feel that a 10 hour working day is too much for a worker. Interestingly,

factories felt that workers were more productive after lunch, although industry reporting suggests

otherwise.

Respondents agree that workers send too much money home and therefore do not have sufficient

funds for themselves to buy basic foods. All respondents agree that if workers eat healthier food, they

will be stronger; however, only 41% of factories felt that workers eat unhealthy food.

The majority of respondents feel that the choices workers make regarding what they eat, is their

personal responsibility. On the other hand, the majority of companies (>50%) agree the companies

should be involved in the challenges related to nutrition and personal care.

Workers do not eat healthy meals and should have access to more hygienic and clean food

services:

Although 33% thought that their workers eat healthy meals, most respondents remained neutral as to

whether or not they would personally eat the food outside the factory gate.

Workers need better access to hygienic and clean food services, whether those are provided by private

or public service providers.

Existing providers need to improve hygiene and cleanliness or be provided with appropriate facilities.

There was a mixed response as to whether ‘cooked meals’ should be provided by street vendors. For

obvious reasons, if street vendors did not provide cooked meals, livelihoods would be lost and the

impact on garment workers and their ability to access food would be a challenge. This would impact

factories as well.

Respondents felt that fruits and snacks varied in hygiene. Respondents noted that if fruits are prepared

and not served in their natural form, there are challenges with cleanliness and hygiene.

Management perceptions on cost of meals

The more healthy meals account for about two third of the minimum wage. Seeking creative ways to be

thrifty with money, whether pooling resources to purchase collectively, bringing food from home (which

also has a cost), or purchasing poor quality products to be able to have more appear necessary for workers

to be able to manage their personal and family responsibilities, is a reality and necessity. Often being thrifty

comes at a cost of foregoing personal health such as skipping meals, or eating less, as research has shown.




Breakfast is generally eaten at home before work or nearby the factory before coming into work. Many

factory workers take lunch from home to the factory to save money. Overall 78 per cent of respondents

noted that workers purchase food outside the factory gate. Unless workers are working overtime or late,

dinner is generally eaten at home. In the event that there is over time, an allowance is provided for workers

to eat.

The cost of providing a meal or subsidizing meals is the most critical factor to decision making.

Managers grapple with access to information around food services provision.

Only two factories in the survey had canteen facilities. While many would consider a canteen facility, it is

clear that information is needed, not only on who can provide the service, but the cost and the real

impact having a canteen will have. A canteen that provides low quality meals and does not demonstrate

health or productivity improvements for factories may have a negative impact on providers in the

canteen services sector.

Fifty six per cent of respondents would consider providing one meal to their workers. Cost is the main

factor for factories to consider providing a meal to workers. Impact on productivity or turnover as a

reason for subsidising meals was not as important as researchers thought it would be, however generally a

key concern for factories overall. Interestingly, snacks, which would assume less challenges as they don’t

require facilities to sit and eat, was not something the majority of respondents would consider, but

additional information on types of snacks and ease of handling might change the views. Of those who

would consider providing one meal, the majority would provide lunch followed by breakfast.

Table 5: The Need for Real Case Studies

Clear case studies showing the link between nutrition and productivity would be a useful tool to

demonstrate gains for factories, including reduction in sick leave and absenteeism. There is a clear need

to answer pertinent questions for factory owners around pursuing canteens or meal services:

1. Will such an effort of canteens and meals genuinely increase productivity and output to cover costs?

2. Since a meal allowance on its own will not increase productivity, how long will it take for an investment

in a canteen and/or meal subsidies to produce tangible outputs in terms of productivity improvement?

3. Will profitability simply be reduced or will the cost of a meal subsidy or allowance need to be passed on

to the product. If to the product, will Cambodia still be an attractive destination for sourcing

production?

4. Is providing additional cash not easier than all the investment and management around a canteen?

Regardless of whether or not workers spend the money on food, from a management and

administration perspective, is this not an easier option to pursue?

5. Will a canteen create more management headaches related to food poisoning and food choices and are

reliable services affordable to the extent that they provide more nutritious food and not be invested in

management and administration fees of a service provider?




Shared canteen facilities can be an Innovative way to address nutrition and health issues, but

will require significant coordination to get stakeholders on board.

A joint facility for a canteen between several factories was generally not something that the respondents

had heard of before. Overall the respondents felt that this would be received well by all stakeholders in the

garment industry, however almost all mentioned that lack space would generally be an issue in the

existing garment factory areas. As the idea for a joint facility was rather new, this could have biased the

positive view of respondents on which stakeholders would contribute to this; a large percentage believe

that government, factory management, unions and buyers would contribute to the development of such

facilities. It is worthwhile to investigate the feasibility of such a facility further, to relieve some of the

pressures on workers and wages.

8.1 General recommendations

Addressing challenges around nutrition and health in the garment sector is a concern to unions, factories,

government and buyers. Given a common starting point and shared concerns, the issues around nutrition

and health can be a topic that parties (buyers, unions, government, and employers) should tackle together.

The business and economic environment has changed significantly from the years of double digit growth,

the financial crises has tested the strength of the industry and its remarkable comeback. That said, the

industry is still fragile, it remains a CMT industry not yet moving up the value chain of garment production,

it relies heavily on “step-by-step” orders rather than long term stability and visibility of what the future

holds. Regional markets are opening up like Myanmar that has a significantly larger population which will

probably become competitive in the ASEAN region. Cost of infrastructure remains a challenge for

Cambodia’s garment industry cost structure. Pressures are mounting on productivity and trying to pull the

skills levels up, another major constraint for the industry. With new social security policies that are not yet

defined and going to have an impact on the employers’ bottom line, employers consistently talk about the

challenges they have in budgeting and maintaining their cost levels. Employers and industry experts have

spoken about the increasing social costs, including monitoring, the additional health US$5 allowance that in

an average factory of 800 – 1200 workers increases the cost base by approximately USD48,000 per year to

USD72,000 per year or 8% overall on the minimum wage, an increase that is already challenging to manage.

The challenges around nutrition and health need to be addressed more broadly than simply putting out a

hand to the employer to pay more. The competitiveness of Cambodia’s garment industry may become

fragile, if additional pressures around nutrition and health are imposed on the employer alone. Challenges

around nutrition and health are not an employer only challenge. They require education from very early

on in life, family support and more broadly, government, union and buyer involvement and participation.

General recommendations and opportunities include:

There is a case for disseminating more information in general around personal care and nutrition.

Factories, unions and buyers could do more in ensuring that workers are informed.

A need to address the issues around nutrition and health in a strategic and coordinated manner

bringing unions, government, employers and buyers to the table.

A need for more information on the costs associated with canteen services and how the introduction

of meals or subsidies has a return for employers.




A need for more information to better understand the link between nutrition, health and productivity

and the tangible effects such as reduction in sick leave, better commitment, lower turnover as

examples.

A need to better understand who the facility management providers are.

A real apparent opportunity to pursue joint facilities if a strategic coordination committee was set up.

A more in-depth feasibility study will be required as space is an issue

A need to improve the “business environment” outside the factory gate by improving hygiene and

cleanliness of service providers. This is mostly a public responsibility and will require standards, rules

and regulations to be set, even licensing of smaller providers or provision of public facilities where

entrepreneurs can sell their goods and services.

8.2 Recommendations for HCFM

HCFM has been providing canteen facility management services to industry for several years now. It is a

leading social enterprise and arguably the leading in facility management services in Cambodia. One of the

objectives of the study is to identify opportunities for HCFM and whether or not the garment industry

would pursue setting up canteens. The following recommendations coming out of the study include:

Factories who participated in the study are interested to see the results of the survey. Several have

also requested to get more information. These will be detailed in a separate briefing for HCFM. To

pursue the sector we feel that there is a need to ensure that pursuit of new business development in

this sector has dedicated business development personnel who are able to build up key relationships

in the sector and pursue business in the sector. Selling canteen services is not an easy sell.

Several factories mentioned that they do not want to have outsiders stationed in the factory for

several reasons. Building up case studies that address employer concerns in this regard is important.

Cost is a key constraint for factories. Basic meals provided by HCFM cost around KHR2000 per

employee. This is a simple soup. Factory managers might view such an expense as too high and rather

provide a subsidy to workers so that they can purchase food stuffs outside the factory. A real case

study needs to be developed around the value added of a canteen (and in particular the added

nutritional value in relation to productivity) and the need to invest in the facilities.

H&M as a buyer showed interest in being involved in nutrition / health issues.

Developing a fact sheet might be useful on the pros of having a canteen as well as reviewing the

different cost models that can be implemented. For example: healthy meals partly subsidized and

employees paying for some of the meals.

Joint facilities appear to be a real opportunity for HCFM to pursue. If HCFM were able to lead a task force

committee, influence government, unions, buyers and employers, this could be a powerful offering to

provide and guarantee market share. Given the limited budget for implementing the survey, and the

apparent interest in innovative ideas such as joint facilities, it might be worth pursuing a more in-depth

feasibility study on join facilities in the future.

Opportunities in the sector exist but will require consistent and sustained interaction with the sector.

While factory managers are interested in getting information, turning an information request into a

revenue generating activity is going to be hard work.




Table 6:Specific recommendations for canteen models22

The nutritional status of workers improves when more money is being spent on it, by employers, unions, government, buyers and by workers themselves.

In all cases ‘collaboration between stakeholders’ can and should be initiated

In all cases HCFM could be a provider of the service or a training provider for others as a specialist in this sector.

Opportunities Challenges

Joint Canteen Services - government, employers, unions, buyers can be involved in setting up a type of food court

Long term coordination – can bring stakeholders together

Can service several factories at any time

Costs for infrastructure, subsidy food etc. can be shared

Build in strategic locations

Nutritional content can be controlled

Need a dedicated team to work on this as it requires many stakeholders to work together on consensus model, who would lead?

Cost factor – who pays what?

Space for infrastructure – where? Workers in city most at risk, propose to start in PP.

Canteen Services – Fixed Facilities - the canteen in the factory and serviced from in the factory.

All in one facility which is easy for the canteen operator to manage

Can show direct link between food and increase in productivity

There are some example factories available as showcases.

Easier to manage responsibilities

Factories have issues with outsiders in their premises

Costs for factory infrastructure could be higher than when pursuing joint facilities

Lack of space

In case of hygiene issues, one whole factory is at risk

Factories do not have enough information on benefits and the operation to look into this.

Canteen Services - Moveable Facilities – temporary facilities that can be moved easily to other areas when needed, similar to wedding party tents plus full kitchens cooking for 100 people at a time.

The infrastructure costs are less

The facility can be moved when factories open/close

Quicker to implement

Hygiene could be more difficult to control

The infrastructure not durable

Canteen Services: On the Run - Cooked before, brought to the factory and served at the factory.

All hygiene can be controlled by the provider at their premises

Very limited infrastructure input for factories

Provider puts up the infrastructure which could serve several factories.

No outsiders in the factory

Delivery and serving at the factory premises

Transportation of big pots with food is inconvenient and could be dangerous (lunchboxes are easier)

Timing is of essence to keep food hygienic

Lunch Boxes -Cost of the lunch box is expensive but in South Asia well tested models with reusable containers.

All hygiene can be controlled by the provider at Transportation of meals could be challenge but

22Framework developed by HRINC (Cambodia) & BDLINK Cambodia Authors




their premises

Very limited infrastructure input for factories

Provider puts up the infrastructure which could serve several factories.

No outsiders in the factory

Well tested model in South Asia in garment industry, with reusable containers – other stakeholders could contribute to container costs and put ‘controlled responsible’ advertising on.

Delivery at the factory premises

could be organised

Timing is of essence to keep food hygienic

Snacks – Fortified Snacks seem to be an efficient way in which to address nutrition issues in particular

Other stakeholder could take part in developing snacks.

A number of ‘processed’ snacks are already available in Cambodia

On processed snacks – health messages could be added or responsible advertising

Natural snacks such as a banana is not that difficult to organize

Very specific nutritional targeting

Snacks do not fall into the HCFM services yet

Train the vendors – Several projects in India and Thailand have undertaken this as industry projects, improving infrastructure of public areas and training vendors. Seemingly successful in that vendors have dramatically improved hygiene and the nutritional status of food.

These are industry wide projects involving employers, workers, government, unions and vendors – given that many people in Cambodia earn a living by selling food to factory workers and they need their livelihood as well, there is something to be said for a combined approach of promoting canteens in some areas and training street food providers in other less appropriate areas.




9 ANNEXES

9.1 Scenarios on the cost of meals vs. income earnings

Given the perceptions of respondents on the cost meals, the team did some calculations to understand the

cost of meals in relation to various income scenarios of workers. Several scenarios based on different

assumptions are outlined below. It is important to note that this is not exhaustive; it tries to attempt to

review the cost of meals as a percentage of various levels of income. Many additional variables could

impact the calculations but have not been included. Salary levels have been drawn from discussions with

factory managers.

The data has been set out by looking at the different types of eating scenarios and how much a worker

spends in total per month. Keeping in mind that food is almost the onlyexpenditureitem that a worker can

use to save money for other expenditures, with scenario 3 being an extremely minimal amount of food.

The different eating scenarios are tabulated by month by multiplying the cost of meals by the total

number of days per month (30.4). The total cost of meals is then divided by the different levels of income

to look at the percentage of income that is spent on meals

Table 7:General assumptions for the different scenarios

Assumption Data Comments

# of days per month 30.4 365 days per year by 12 months. Calculations assume that workers need to eat every day of the year.

Conversion Rate Used KHR4000 Exchange rate is currently higher than 4000 Riel.

Minimum Wage USD61 Minimum wage without incentives

Average Take Home Earnings

USD90 The average amount of money a worker takes home including over time and incentives (assumed overtime is 2 hours/day – 60 hour work week).

Median-end Earnings Take Home

USD110 Workers that are more skilled and earn higher incentives due to increased productivity levels.

High-end Earnings Take Home

USD130 Highly productive workers including overtime and incentives.




Table 8:General assumptions on cost of eating scenarios

% of Monthly Wage (@ 30.4 days/per month

@4000Riel=1$)

Assumption Meal Cost in KHR $61 $90 $110 $130

Eating Scenario 1

Breakfast 800

64% 43% 35% 30% Lunch 1,800

Dinner 2,500

Per day $1.28 5,100 $38.76 $38.76 $38.76 $38.76

Eating Scenario 2

Breakfast 600

51% 35% 28% 24% Lunch 1,500

Dinner 2,000

Per day $1.03 4,100 $31.16 $31.16 $31.16 $31.16

Eating Scenario 3

Breakfast 500

31% 21% 17% 15% Lunch 1,000

Dinner 1,000

Per day $0.63 2,500 $19.00 $19.00 $19.00 $19.00

Note: Authors calculation and survey results

Table 9:Typical income and expenses according to the Workers’ Rights Consortium

Calculations form the Asia Floor wage presentation (wage 2011)

Typical Wage per month Added column for Wage Incl. OT (by

author)

Wage 2011 $61.00 $90.00

Rent & utilities $8.00 $8.00

Remittances $17.00 $17.00

Personal expenses $5.00 $5.00

Remaining for food $31.00 $60.00

Food expenditure/day $1.00 $1.94

Food expenditure/day in Riel 4000/day 8000/day

Source: People's Tribunal on Asia Minimum Floor Wage Cambodia, Feb 2012, presentation by Bent Gehrt, Workers Rights Consortium

Although it is possible to have 8000 Riel per day to spend on food (when assuming a $90 monthly wage, see

above), as food is one of the few expenditures that workers can influence it seems very likely that they

would spend less on food than 8000Riel and use the saving for other expenditures. Therefore the eating

scenarios in table 2 seem still appropriate, including the 4000Riel scenario as well as a 5100Riel scenario.

For all scenarios the percentages spent on food range from 31%- 64%, when workers earn a minimum wage

only. The expenditure on food for a $90 monthly wage still ranges from 21% to 43%. This wage is the most

common take home wage and includes overtime.




9.1.1 Caloric Intake

The Workers’ Rights Consortium analysed a workers’ typical breakfast and lunch to identify how many

calories were available, both samples showed deficits in caloric intake. They assumed 2200 calories per day

minimum, divided by 3 meals this is 733 per meal. Both the breakfast and lunch came short of calories, see

below.

Table 10: Caloric intake of workers’ (especially when living in Phnom Penh)

BREAKFAST Weight/

gram

# calories

/100gram Total calories

Calorie demand per day 2200

(2200/3=733 per meal)

Rice 200 168 336

Deficit of 333 Pork est. 50-60Kcal

60

TOTAL including some

vegetables 400

LUNCH

Soup 200 76 152

Deficit of 161 Rice 250 168 420

TOTAL calories

572

Possible TOTAL deficit in

calories for 2 meals of a day CALORIES 494

Source: People's Tribunal on Asia Minimum Floor Wage Cambodia, Feb 2012, presentation by Bent Gehrt, Workers Rights Consortium




9.1.2 Cost of a workers’ meal and economic data

As part of the presentation of the different scenario we analysed the cost price of a simple meal, without a

vendors profit and with minimum amounts of food, 200gram of rice and 50gram of protein based on the

above information.

Table 11: Key economic indicators in relation to the cost of a workers’ meal

Note: the # grams based on the calorie overview in Table 10: Caloric

intake of workers’ (especially when living in Phnom Penh.

The above shows clearly that unless food is watered down and protein quantities are minimized (and rice

quantities increased as the cheapest ingredient per kg) food is expensive and for 4000 Riel a day one does

not get enough calories to work hard.

This case study shows that addressing challenges around nutrition and health in the garment sector is

challenging.

Pressures are mounting on productivity in the industry and trying to pull the skills levels up, another major constraint for the industry.

New social security policies (that are not yet defined) are going to have an impact on the employer bottom line, employers consistently talk about the challenges they have in budgeting and maintaining their cost levels. For example the health allowance of an additional US$5 per month per worker, increases the cost base of an average factory 800 – 1200 workers by approximately USD48,000 per year to USD72,000 per year or 8% overall on the minimum wage. It is understandable that such an increase would be relatively challenging to manage.

The challenges around nutrition and health are going to need to be addressed more broadly than simply

putting out a hand to the employer to pay more. The competitiveness of Cambodia’s garment industry may

become fragile, if additional pressures around nutrition and health are imposed on the employer alone.

Local market Prices 16-1-2012

Meals

Meal Content

Price per kg in Riel

Per meal - content in

grams

Cost in

Riel

Cost price in Riel for 1 meal of 200gr rice +

50gr protein – no profit for vendor

included

*3 meals/

day Riel

rice 2800 200 560 560 rice only 1680

beef 30700 50 153

5 2095 rice+beef 6285

fish 12300 50 615 1175 rice+fish 3525

pork 18700 50 935 1495 rice+pork 4485

chicken 19000 50 950 1510 rice+chicken 4530

Key Economic Indicator

(21 Jul 2011)

2012p 2011p

GDP (million US$) 14,120 12,792

GDP Growth Rate 6.6% 8.7%

GDP per Capita (US$) 958 879

Inflation (Dec/Dec) 4.5% 6.3%

Source: EIC Projections

Local Market News (16

Jan 2012)

KHR per Unit -

16 Jan 2012

Year ago

Gasoline (per L) 5,250 4,700

Rice (per Kg) 2,800 2,600

Fish (per Kg) 12,300 12,300

Beef (per Kg 30,700 23,000

Pork (per Kg) 18,700 16,000

Chicken (per Kg) 19,000 16,500

Currency News 16 Jan 2012 Year ago

Cambodian Riel/US$ 4,072 4,052

Source:www.eicambodia.org:- 22 January 2012




9.2 Reference Materials

9.2.1 Typhoid

Table 12:Briefing on Typhoid

TYPHOID

Typhoid fever is caused by an infection with the bacteria Salmonella typhi, a bacterium that can only live in humans. People with

typhoid fever carry the bacteria in their bloodstream and intestinal tract. About 3 to 5 per cent of people still carry the bacteria,

even if symptoms go away with proper treatment. These people are known as typhoid fever carriers. You can get typhoid fever

if you eat food or drink beverages that have been handled by a person who is shedding the bacteria, or if sewage contaminated

with the bacteria gets into the water you use for drinking or washing food.

Therefore, typhoid fever is more common in areas of the world where hand washing is less frequent and water is more likely to

be contaminated with sewage.

The most common typhoid fever symptoms include

Fever as high as 39° to 40° C / general ill-feeling / Weakness / Stomach pains / Headache/ Loss of appetite / Decreased heart rate / Severe diarrhoea / Constipation / Bloody nose / Rash of flat, rose-coloured spots.

Preventing typhoid

Buy bottled water or bring it to a rolling boil for one minute before drinking.

Drinks without ice, unless the ice is made from bottled or boiled water. Avoid Ice drinks and flavoured ices that may have been made with contaminated water.

Eat foods that have been thoroughly cooked and that are still hot and steaming.

Avoid raw vegetables and fruits that cannot be peeled. Vegetables like lettuce are easily contaminated and are very hard to wash well.

When you eat raw fruit or vegetables that can be peeled, peel them yourself. (Wash your hands with soap first.) Do not eat the peelings.

Avoid foods and beverages from street vendors. It is difficult for food to be kept clean on the street.

Wash hands and feet frequently and thoroughly, with a soap, particularly, after you return from out.

Nutritive measures are the most significant, vital and the only way of bringing about a lasting cure fortyphoid.

http://constipation.emedtv.com/constipation/constipation.html




9.3 Value of Garments Manufacturing in relation to Cambodia’s GDP23

Figure 29: Contribution to Cambodia's GDP per 3 main Industries of origin (at constant 2000 prices)24

Figure 30: Contribution to Cambodia’s GDP per industry of origin (at constant 2000 prices)25

Figure 31: Cambodian Exports 2011 (in USD)26 Figure 32: Garment and Shoes export division, 2011(in USD)19

As of

23January 2011

24Source: Economics Today: Cambodia’s business Magazine, Cambodia Economic Watch January 2011 (Volume 5, Number 79), p. 55

25Source: Economics Today: Cambodia’s business Magazine, Cambodia Economic Watch January 2011 (Volume 5, Number 79), p. 55

26Source: http://www.phnompenhpost.com/index.php/2012012054043/Business/export-figures-up-42-in-2011.html, May Kunmakara , Friday, 20 January 2012

http://www.phnompenhpost.com/index.php/2012012054043/Business/export-figures-up-42-in-2011.html

Documents

Nutrition and Feasiblity of Canteens